WCRI Studies Link Fee Schedules to Lower Payments

States that do not a have fee schedule in place are likely to pay more for workers’ compensation-related medical services, according to two Workers Compensation Research Institute (WCRI) studies that analyzed the medical price index, prices paid for professional services, and the hospital cost index, the payments made for outpatient services.

The two studies examined the impact of fee schedules on prices in workers’ compensation claims. In the medical price index study, WCRI Medical Price Index for Workers Compensation, Dr. Rebecca Yang, analyzed claims with prices paid for professional services during 2002 through 2012 in 25 states. In the hospital outpatient cost index analysis, Hospital Outpatient Cost Index for Workers’ Compensation, Dr. Yang reviewed hospital outpatient payments related to surgeries made during 2005 through 2010 in 20 large states.

The WCRI researcher found that fee schedules do affecting pricing and that fees paid for professional services varied greatly. States that did not have fee schedules paid more for professional services and hospital outpatient payments, while states that had a fixed amount fee schedule paid less. According to the study, the median states were Louisiana and Arizona. Wisconsin recorded the highest prices paid for professional services.